Individual provider Active NPI

Jessica Ilish Filipski, PA

  • Physician Assistant
  • South Bend, IN
National Provider Identifier
1366100604
Registry record updated Aug 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10003393A Issued in IN
Practice address
1815 E Ireland Rd
South Bend, IN 46614-2845
Phone
(574) 647-1700
Fax
(574) 647-7572
NPI assigned
Dec 3, 2021
Sex
Female
Sole proprietor
No

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Beacon Medical Group Inc 575 clinicians

Practice addresses (Care Compare)

100 Navarre PL
South Bend, IN 46601-1171

1815 E Ireland Rd
South Bend, IN 46614-2845

615 N Michigan St
South Bend, IN 46601-1033

615 N Michigan St FL
South Bend, IN 46601-1033

Hospital & facility affiliations

  • Memorial Hospital of South Bend Hospital, South Bend, IN, CCN 150058

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
I20220422000772 IN Practitioner - Physician Assistant 1153718010 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
10003393AINMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Beacon Medical Group Inc CurrentSince Apr 11, 2022 Accepting new patients
Beacon Medical Group, Inc. Physician Assistant CurrentSince Apr 11, 2022 Accepting new patients
Beacon Medical Group, Inc. Past Accepting new patients

Locations

3245 Health Dr
Ste 100
Granger, IN 46530
Phone (574) 647-2129

900 I St
Laporte, IN 46350
Phone (219) 324-1670

100 Navarre Pl
Ste 4440
South Bend, IN 46601
Phone (574) 647-4540

1815 E Ireland Rd
South Bend, IN 46614
Phone (574) 647-1700

710 N Niles Ave
South Bend, IN 46617
Phone (574) 647-1610

615 N Michigan St
South Bend, IN 46601
Phone (574) 647-1000

615 N Michigan St
Fl 1
South Bend, IN 46601
Phone (574) 647-1100

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 10003393A IN Primary

Addresses

NPPES NPI Registry

Primary practice location

1815 E Ireland Rd
South Bend, IN 46614-2845

Mailing address

3245 Health Dr.
Suite 100
Granger, IN 46530-3245
Phone (547) 647-1840

Other practice location 1

100 Navarre Pl
Ste 4440
South Bend, IN 46601-1171
Phone (574) 647-5300

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
300093344MedicaidIN

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 2, 2024.

{
    "created_epoch": "1638489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722556800000",
    "number": "1366100604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3245 HEALTH DR.",
            "address_2": "SUITE 100",
            "city": "GRANGER",
            "state": "IN",
            "postal_code": "465303245",
            "telephone_number": "547-647-1840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1815 E IRELAND RD",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466142845",
            "telephone_number": "574-647-1700",
            "fax_number": "574-647-7572"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Navarre Pl",
            "address_2": "Ste 4440",
            "address_purpose": "LOCATION",
            "city": "South Bend",
            "state": "IN",
            "postal_code": "466011171",
            "country_code": "US",
            "telephone_number": "574-647-5300",
            "fax_number": "574-647-5305",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FILIPSKI",
        "first_name": "JESSICA",
        "middle_name": "ILISH",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-03",
        "last_updated": "2024-08-02",
        "certification_date": "2024-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10003393A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300093344",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South Bend, IN

Sources for this page

Verify at the official NPI Registry.